How computers will replace doctors

Your doctor can only process so many details at one time. Computers can process many times more data in seconds.

 By Bernard Thompson

Do you ever wonder how good your doctor is?

When you go that that person's surgery, you are often literally putting your life in their hands but how do you measure their competence?

Naturally, doctors are people and people are imperfect so, logically, some are better than others. But, however good or bad they may be – and their patients are often in no position judge – you generally do what they tell you to do.

You put chemicals into your body at their behest, eat what they tell you to, have them make decisions for your children and trust them to spot if you are suffering from a life-threatening condition, even when you may feel quite healthy.

Thankfully, they are highly trained, mostly for about seven years at university, followed by years of practice.

But here's the rub – when you strip away the title and the aura that comes with being called “doctor”, effectively you are looking at a knowledge bank which monitors symptoms.

If they are specialists, their knowledge and experience will be highly-specific and they will have access to high-tech equipment. But when you think about it, it's technology that is advancing medical science far more than doctors.

And that suggests that doctors will one day – perhaps sooner than you imagine – be replaced by computers.

In fact, it is not too far-fetched to suggest that most people graduating in medicine today will be redundant by the time they are 60.

Doctors check symptoms and match them to knowledge they have from their training with imperfect recall and based on facts largely restricted to their medical culture.

Measuring temperature, breathing, heart-rate and blood pressure are easy, with equipment that anyone could buy at home.

Blood, urine, etc. get sent to a lab for chemical tests.

Doctors will look into your eyes and listen to your breathing but a machine could do either to a higher degree of accuracy.

They will prod you, feel around inside you but the most detailed information comes from x-rays, heart-monitors and body scanners.

That's leaving the only key human elements being the doctor's knowledge, based on your records, their empathy and instincts.

And this is where big data processing will eventually make doctors virtually redundant. Imagine a database that has every medical record in history, every medical journal, all available data on the effectiveness of every treatment worldwide.

“AI won’t replace radiologists, but radiologists who use AI will replace radiologists who don’t.”

The process has already begun in radiology.

A highly specialised field, radiology entails diagnosing and treating disease and injury, using medical imaging techniques such as X-rays, computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine, positron emission tomography (PET), fusion imaging, and ultrasound.

But, as these outputs are prepared digitally, they can be assessed more accurately by computers using artificial intelligence than by even the best-trained humans.

In 2012, Sun Microsystems co-founder, Vinod Khosla, predicted that algorithms would replace 80 per cent of doctors, and later claimed that radiologists still practising in another 10 years would be “killing patients.”

Curtis Langlotz, a radiologist at Stanford, had a less dramatic view: “AI won’t replace radiologists, but radiologists who use AI will replace radiologists who don’t”.

The first algorithm allowed to make a medical decision without the need for a doctor to check the image was approved by the US Food and Drug Administration (FDA) in 2018.

IDx Technology's program examines retinal images to detect diabetic retinopathy and is 87 percent accurate. And, as no doctor is involved, the company has full legal liability for any medical errors.

Your doctor can only process so many details at one time. Computers can process many times more data in seconds.

Culture

It's well worth remembering that medical decisions are not simply a matter of objective science.

Doctors in different countries often have different approaches to medical care, for example being more or less likely to perform Caesarian sections at an early stage in labour.

That means that your treatment is not solely guided by what is best for you, but also by the medical culture.

But it doesn't have to be that way. Pooling that data would allow a verifiable method of establishing what is statistically the best treatment for you.

Imagine that information being applied to you, specifically, in the most minute detail.

The speed with which enormous amounts of data can be evaluated is what is likely to make this revolution happen.

Your doctor can only process so many details at one time. Computers can process many times more data in seconds. They can also identify associations that traditionally come around through specific tests or by chance.

Franks' sign, for example, (a diagonal crease on the earlobe) has been linked to cardiovascular disease, diabetes and risk of stroke.

But we are on the cusp of an era in which computers will be able to identify patterns based on symptoms that even the majority of doctors wouldn't notice. Maybe people with red hair tend to respond better to certain medication. Perhaps people with long index fingers are more prone to certain conditions.

The computers will store all this data about you and cross-reference it against billions of others across the world and throughout the ages.

They will instantly know what the latest treatments are and calculate their risks and likelihoods of success to less than a degree.

Corporate resistance

The choice of medication, therefore, should not be influenced by the drug company reps who took your doctor on a trip to Paris but by what is best for you.

As with many things, corporate resistance will be one of the biggest obstacles to be overcome as Big Pharma will not wish to allow the production of generic medicines - or to lose the advantages of having highly-incentivised sales teams lobbying providers of medical care.

Nevertheless, the day will come when it will be possible to produce medication to exactly match your body chemistry, perhaps even 3-D-printed for you at home.

But what about the human touch? Well, that is a real benefit but think about this: how many times have you had an unpleasant or even upsetting encounter with a medical professional?

Wouldn't a cold machine be, in some ways, better? And, furthermore, artificially intelligent robots will very soon be able to replicate empathetic behaviour, so talking to a nice “person” who know exactly what to say, will also be possible.

Set against the potential that technology brings, it should be easy to see how doctors can and largely will be replaced and this will not be limited to diagnosis and medication.

Operations

Mehran Anvari controls his robot surgeon, conducting a keyhole surgery
(St Joseph's Healthcare)

Operations are already being carried out remotely by doctors controlling robots. Eventually, that robot will be autonomous, and not subject to errors of judgement or fatigue. That robot, without shaky hands, will be able to perform 24 hours a day, seven days a week, without its performance being impaired.

Do your governments actually want you to know that an expensive treatment in a far-off land has a  higher success rate than the one that is offered in your area?

Politics, economics, ethics

The questions this will raise will be largely political, economic and ethical.

Do your governments actually want you to know that an expensive treatment in a far-off land has a  higher success rate than the one that is offered in your area? (As in the case of Ashya King.)

How long do your governments really want you to live? (Improved accuracy of medical care will inevitably lead to increased longevity).

At what point will they actually withhold information from the patients and will they create an algorithm to decide just how effective your treatment is allowed to be?

Will the same computers evaluate your viability as a human and your right to good health? And, if so, what criteria will they use?

We will need answers to these questions – and soon. In the meantime, young medical students should be cautious before imagining that they are on a path to their job for life and bear in mind that, one day, they may need a new career.

Updated: March 2020